MEDICARE: MR. JAY ERIC ITZKOWITZ MSPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT16815	FL

General Provider Information

NPI Number	:	1801895586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAY ERIC ITZKOWITZ MSPT

Provider Business Mailing Address
First Line	:	9980 CENTRAL PARK BLVD N
Second Line	:	SUITE 220
City	:	BOCA RATON
State	:	FL
Zip	:	33428-1762
Country	:	US
Telephone Number	:	561-558-8898
Fax Number	:

Provider Business Practice Location Address
First Line	:	9980 CENTRAL PARK BLVD N
Second Line	:	SUITE 220
City	:	BOCA RATON
State	:	FL
Zip	:	33428-1762
Country	:	US
Telephone Number	:	561-558-8898
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	11/03/2011

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